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Associations between contrast-enhanced ultrasound features and WHO/ISUP grade of clear cell renal cell carcinoma: a retrospective study

  • Nephrology - Original Paper
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Abstract

Background

Clear cell renal cell carcinoma (CCRCC) comprises 70%–80% of RCCs. The World Health Organization/International Society of Urology Pathology (WHO/ISUP) classification is the most important prognostic factor for CCRCC. By evaluating the variations of tumor microvascular density, contrast-enhanced ultrasound (CEUS) can noninvasively predict the WHO/ISUP grade of CCRCC, and provide the appropriate treatment plan before clinical operation.

Methods

In this study, we used CEUS features to analyze 116 CCRCC cases and assess the value of correlation between each indicator and CCRCC WHO/ISUP grading.

Results

When compared to high-grade (WHO/ISUP grade III/IV) tumors, low-grade (WHO/ISUP grade I/II) tumors had reduced relative peak intensity (ΔPI) (P = 0.021), relative area under the curve (ΔAUC) (P = 0.019). However, the frequency of incomplete pseudocapsule (P = 0.021) was significantly higher in high-grade tumors. A cut-off value of mean diameter > 5.5 cm, ΔPI > 304 × 10–3, ΔAUC > 350 × 10–3 allowed identification of high-grade tumors with an area under the curve (AUC) of 74.6%, 71.7%, 70.7%, respectively (95% confidence interval).

Conclusions

The features of CEUS are effective for differentiating high-grade tumors from low-grade tumors, thus CEUS can be considered an acceptable method for the preoperative assessment of tumor grade.

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Data availability

The authors confirm that the data supporting the fingdings of this study are  available within the article.

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Acknowledgements

I would like to express my gratitude to all those who helped me during the writing of this thesis. I gratefully acknowledge the help of my supervisor, Ms. Ye Qin, who has offered me valuable suggestions in the academic studies. She has spent much time reading through each draft and provided me with inspiring advice.

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Authors and Affiliations

  1. Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou City, Fujian Province, China

    Xiaoqing Fan, Fen Fu, Rongxi Liang, Ensheng Xue, Huiping Zhang, Yifan Zhu & Qin Ye

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  1. Xiaoqing Fan
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  2. Fen Fu
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  3. Rongxi Liang
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  4. Ensheng Xue
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  5. Huiping Zhang
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  6. Yifan Zhu
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  7. Qin Ye
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Contributions

X-QF and QY conceived and designed the study. X-QF wrote the initial version of the manuscript and constructed the figures and tables. FF, H-PZ and Y-FZ acquired and analyzed the data. QY, S-EX, and R-XL contributed to the critical revision of the manuscript, figures, and tables. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Qin Ye.

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Ethical approval

The studies involving human participants were reviewed and approved by the ethics committee of Fujian Medical University Union Hospital. Written informed consent for participation was required for this study in accordance with the national legislation and the institutional requirements.

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Fan, X., Fu, F., Liang, R. et al. Associations between contrast-enhanced ultrasound features and WHO/ISUP grade of clear cell renal cell carcinoma: a retrospective study. Int Urol Nephrol 56, 1157–1164 (2024). https://doi.org/10.1007/s11255-023-03774-z

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  • DOI: https://doi.org/10.1007/s11255-023-03774-z

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